Annals of Coloproctology

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Case Report

Benign proctology,Rare disease & stoma

Extraperitoneal Spread of Anorectal Abscess: A Case Report and Literature Review: Papadopoulos S. Konstantinos, Dimopoulos Andreas, Kordeni Kleoniki, Filis Dimitrios; Ann Coloproctol. 2021;37(Suppl 1):S11-S14. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2020.01.20

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7 Citations

Supralevator abscess is a rare form of anorectal disease responsible for very rare but morbid manifestations, one of which is superior spread through fascial planes. We present a rare case of a spreading anorectal abscess in a patient who presented with only diffuse abdominal pain, and we review similar cases in the literature according to anatomical considerations, presentation, diagnostic procedures, and treatment options. We identified 7 previously reported cases of spreading anorectal abscesses. Most abscesses had a horseshoe morphology, and all patients presented or developed abdominal pain. All patients had perianal swelling and pain. Five out of 7 patients were previously mistreated. Only 2 abscesses spread through both the pre- and retroperitoneal planes. Abdominal pain is a dominant feature of extraperitoneal inflammation originating from anorectal abscesses. The absence of perianal signs is rare, and proper inspection of the patient along with the medical history can lead to quicker diagnosis and decisive treatment.

Citations

Citations to this article as recorded by

Fused Ischiorectal Phlegmon with Pre- and Retroperitoneal Extension: Case Report and Narrative Literature Review
Laurențiu Augustus Barbu, Liviu Vasile, Liliana Cercelaru, Ionică-Daniel Vîlcea, Valeriu Șurlin, Stelian-Stefaniță Mogoantă, Gabriel Florin Răzvan Mogoș, Tiberiu Stefăniță Țenea Cojan, Nicolae-Dragoș Mărgăritescu
Journal of Clinical Medicine.2025; 14(14): 4959. CrossRef
A case of supralevator abscesses involving the prostate and rectum: Formation of a deep and concealed fistula
Feng Chen, Xudan Weng, Yan Li, Jianquan Zhong
Asian Journal of Surgery.2025;[Epub] CrossRef
Ischiorectal abscess with retroperitoneal extension: masquerading as an appendicular abscess
Kalyani Dnyaneshwar Aher, Minakshi Gadhire, Naman Jain, Prafulla Salunkhe
International Surgery Journal.2025; 12(10): 1886. CrossRef
Innovative dual-access surgical strategy for advanced pelvic Fournier’s gangrene: a retrospective study assessing combined suprapubic and transsacral debridement
Zhi-Min Liu, Guo-Zhong Xiao, Jie Huang, Xin Jin, Neng-Sheng Lai, Xing-Yang Wan, Hong-Cheng Lin
BMC Gastroenterology.2025;[Epub] CrossRef
Perirectal Abscess with Anterior Extension to the Extraperitoneum and Space of Retzius: A Case Report
Hsiang Teng, Po-Hsien Wu
Medicina.2024; 60(2): 293. CrossRef
A Clinical-Anatomical-Radiological Study of Extraperitoneal Spaces: A Case Series
Giridhar Ashwath, Eshwar Kathiresan Manasijan, Logeshbalaji Seelampatti Palanisamy, Anthony P Rozario, Nachiket Shankar
Cureus.2024;[Epub] CrossRef
Complex Tunneling Perirectal Abscess: Intra-abdominal and Extraperitoneal Extension of a Persistent Perirectal Abscess
Abenezer S Tedla, Harsh R Parikh, Savni Satoskar, Jigyasha Pradhan, Shailja Kataria, Vinayak S Gowda
Cureus.2024;[Epub] CrossRef

Original Article

The Use of a Staged Drainage Seton for the Treatment of Anal Fistulae or Fistulous Abscesses: Cheong Ho Lim, Hyeon Keun Shin, Wook Ho Kang, Chan Ho Park, Sa Min Hong, Seung Kyu Jeong, June Young Kim, Hyung Kyu Yang; J Korean Soc Coloproctol. 2012;28(6):309-314. Published online December 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.6.309

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29 Citations

Abstract PDF

Purpose

The aim of this retrospective study was to evaluate the rate of recurrence and incontinence after the treatment of fistulae or fistulous abscesses by using the staged drainage seton method.

Methods

According to the condition, a drainage seton alone or a drainage seton combined with internal opening (IO) closure and relocation of the seton was used. After a period of time, the seton was changed with 3-0 nylon; then, after another period of time, the authors terminated the treatment by removing the 3-0 nylon. Telephone interviews were used for follow-up. The following were evaluated: the relationship between the type of fistula and recurrence; the relationship between the type of fistula and the period of treatment; the relationship between the recurrence and presence of abscess; the relationship between IO closure and recurrence; the relationship between the period of seton change and recurrence; reported continence for flatus, liquid stool, and solid stool.

Results

The recurrence rate of fistulae or suppuration was 6.5%, but for cases of horseshoe extension, the recurrence rate was 57.1%. The rate of recurrence was related to the type of fistula (P = 0.001). Incontinence developed in 3.8% of the cases. No statistically significant relationship was found between the rate of recurrence and the presence of an abscess or between the closure of the IO and the period of seton change or removal.

Conclusion

In the treatment of anal fistulae or fistulous abscesses, the use of a staged drainage seton can reduce the rate of recurrence and incontinence.

Citations

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Koloproktologia.2024; 23(4): 94. CrossRef
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Ambulatory seton placement followed by fistulotomy: efficacy and safety for perianal fistula treatment
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European Journal of Gastroenterology & Hepatology.2021; 33(7): 956. CrossRef
Influence of the cotton and silastic seton on the distance of the anal sphincter cables after fistulotomy in rats
Ana Laura Sanches Lima, Beatriz Schorro Gianini, Bruna Miranda Santana, Carlos Henrique Marques dos Santos, Doroty Mesquita Dourado, Juliano Seger Falcão, Lucas Bannwart, Sara Jéssica Falcão Câmara
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ANZ Journal of Surgery.2020; 90(9): 1764. CrossRef
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Shah Huzaifa Feroz, Asma Ahmed, Abilash Muralidharan, Pragatheeshwar Thirunavukarasu
Cureus.2020;[Epub] CrossRef
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World Journal of Colorectal Surgery.2020; 9(4): 64. CrossRef
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Hasan Calis
Acta Medica Alanya.2019; 3(1): 67. CrossRef
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A. I. Musin, E. V. Antipova, A. A. Ulyanov, D. E. Kuznetsov
Grekov's Bulletin of Surgery.2019; 178(2): 79. CrossRef
Drainage Seton Versus External Anal Sphincter–Sparing Seton After Rerouting of the Fistula Tract in the Treatment of Complex Anal Fistula: A Randomized Controlled Trial
Waleed Omar, Abdallah Alqasaby, Mahmoud Abdelnaby, Mohamed Youssef, Mostafa Shalaby, Mohamed Anwar Abdel-Razik, Sameh Hany Emile
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Yasmine Hubbard, Denise Rizzolo
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Draining Setons as Definitive Management of Fistula-in-Ano
Oluwatomilayo O. Daodu, Julia O’Keefe, John A. Heine
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Journal of Coloproctology.2018; 38(03): 199. CrossRef
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